Inspirational Black Men and Women in Medicine: Dr. Elizabeth P. Clayborne On 5 Things You Need To Create A Successful Career In Medicine

An Interview With Jamie Hemmings

People have more trust in doctors they can relate to. Consider this. Black men live 4.6 years less than non-Hispanic white men. There are many reasons for this, including a lack of trust by Black in the healthcare system. Studies suggest that black patients feel a black doctor better understands their concerns. It facilitates communication and the sharing of potentially life-saving information that a patient and provider must exchange for care. In other words, the studies suggest that black patients trust black doctors.

In the United States today, black doctors are vastly underrepresented. Only 5% of physicians nationwide are black. Why is it so important to have better representation? What steps can be taken to fix this discrepancy? In this interview series, we are talking to successful black men and women in medicine about their career, their accomplishments, and how others may follow their path. As a part of this series, I had the distinct pleasure of interviewing Dr. Elizabeth P. Clayborne, MD, MA.

Dr. Elizabeth “Liz” P. Clayborne is an emergency medicine physician, innovator, and founder of NasaClip, a novel, hands-free nosebleed rescue device developed to help anyone anywhere stop nosebleeds fast. Dr. Liz brings an in-depth perspective from her real-life experiences as a minority entrepreneur, mother of two, and a working physician who has been on the front lines helping patients with urgent medical needs. Dr. Liz serves as a thought leader and national media expert on ethics, end-of-life care, and health inequities and serves as a faculty member with the University of Maryland School of Medicine Department of Emergency Medicine.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your childhood “backstory”?

As the eldest of four daughters and a biracial child, born to a white mother and black father, I could easily fall prey to societal bias and the insecurities it placed upon my own personal identification. Perhaps, it’s what has propelled my drive, pursuit of excellence, and need to achieve. That said, I always saw myself as someone who was seeking a better way– improving systems, processes, and people for the greater good. I wanted to right the wrongs and inequities of the world, pushing boundaries, stretching norms, and exploring new possibilities — all in the vein of pushing myself to maximum growth potential and serving as a leader of excellence to others, especially those who looked like me, along the way.

This mindset followed me early on when as a high school student-athlete, I became the first female kicker on an all-male football team, and later while attending undergrad school at Duke University, I designed my own college major in Medical Ethics and Religion. I then delved deep into research focusing on race, ethnicity, and genetics as part of a two-year intramural fellowship at the National Institutes of Health in the Social and Behavioral Research Branch of the National Human Genome Research Institute. This same drive pushed me to then pursue and complete a dual MD/MA Bioethics degree in 4 years–a feat unto itself.

Can you tell us a story about what brought you to this specific career path?

I entered the field of medicine because I saw it as the clearest professional path to make a real difference in the lives of others, especially those marginalized by society who needed a better voice to express their concerns and fight for their rights. I soon realized that the healthcare system in which I was going to be practicing was riddled with its own set of inefficiencies and implicit racial bias that plagues communities from underserved environments and especially patients who are Black and Brown. I continuously sought out ways to make health care better for all but was particularly drawn to emergency medicine because I saw it as the front lines of medicine. I enjoyed seeing all walks of life, from a senator to a homeless man, a newborn baby to a 100-year-old veteran, and everyone in between. Emergency medicine provides a unique lens to the faults in our healthcare system and we are the first to examine the puzzle of a patient presentation and evaluate how best to help them navigate our fractured healthcare system.

My route to entrepreneurship came from seeing how things in the ER could be done better. I saw patients often who came to the ER with nosebleeds. Nosebleeds are messy, scary, and anxiety provoking but they are usually not emergent, so when patients come to the ER with a nosebleed, they have to wait to be seen. This is, of course, frustrating to them. And during the pandemic heightened the need to shift care to the outpatient system or at home when possible. Nosebleed treatment in the ER can be inefficient, and I wanted to change that. I wanted to empower nurses, PAs, and providers to help patients with nosebleeds as soon as they step in the door and minimize the time physicians need to successfully discharge patients. I wanted to give people a resource to stop nosebleeds in any environment so they wouldn’t have to go to the ER or urgent care where they would often wait and expose themselves to infectious diseases. That’s why NasaClip was created. I saw a problem in the ED that I was experiencing and I wanted to provide a solution that would help patients and healthcare providers alike.

NasaClip helps nurses, mid-levels, caretakers, coaches, and trainers to stop a patient’s nosebleed without a physician’s intervention. They can also send patients home with a device to use themselves in case there is any re-bleeding. People can avoid the ER and it helps free up physician resources to focus on the most serious cases. NasaClip helps make the system more efficient for everyone.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Every great dream begins with a dreamer. Always remember, you have within you the strength, the patience, and the passion to reach for the stars to change the world.”

–Harriet Tubman

I was fortunate to be raised from a young age to believe I could accomplish anything. It was not outlandish for me to pursue any career path or desire any station in life. Despite growing older and seeing several ways in which a seemingly impenetrable glass ceiling existed for women and especially women of color, I continue to believe that I can accomplish anything. Being a big dreamer has carried me this far in my career and my life. I can’t wait to see me touch the stars and change the world.

Can you share the most interesting story that happened to you since you began your career?

I was six months pregnant when the COVID-19 pandemic hit. As a busy young mom and emergency physician working in a hospital just outside of Washington, DC, I already had a full plate. Managing a sixteen-month-old at home, juggling my new academic career and caring for an underserved and sick patient population while growing my nosebleed medical device startup company, NasaClip, already had me maxed out. I remember when I first started to hear rumors about the coronavirus, back then we hardly knew what to expect but ER docs are always aware that they are likely the first to encounter patients with a new illness and I wasn’t particularly worried. My only angst was that I was pregnant with my second child and I knew that being pregnant wasn’t particularly conducive to being an emergency physician. We often work long and odd hours, spend a lot of time on our feet and frequently manage a chaotic and stressful environment. I was excited that two of my female physician colleagues were also pregnant, all of us with our second child, and all of us having girls. We were happily planning play dates for maternity leave and had no idea what was on the horizon for each of us and the difficult decisions we would make in the coming weeks.

It seemed like overnight things changed. All of a sudden there was a flood of sick patients, arriving in respiratory distress with dangerously low oxygen saturations. None of us had seen anything like it. I was pronouncing people dead on a daily basis and some of them were close to my age, it was terrifying. It was around this time that I started to do some local and national media. It was important to me to represent a knowledgeable and articulate female physician of color who could shed light on issues that I thought were important and not getting enough attention. I did several TV interviews and wrote op-eds describing my experience as a pregnant frontline provider and discussed why my two pregnant colleagues and I decided to stick it out in the ER as we battled through the first wave. It became clear to me that several health policy issues that I had always been passionate about were now front and center on the global stage.

And just like that, I went from ER mom doc to a national public speaker who was proud to represent Black excellence at such a critical time. I continue to do a myriad of interviews on networks such as CNN, CNBC, Yahoo! Finance and MSNBC. I even did a TEDx talk entitled “How to protect your body and your doctor’s soul during Covid-19”. My experience as a woman of color, an emergency physician, and a mother has highlighted different challenges, priorities, and resiliencies that are all a part of the human spirit. I hope that we continue to learn from the COVID-19 pandemic and find the silver lining. This experience should have brought us closer together and it is disappointing to see the ways in which society is more divided than ever. We must grow and learn from the immense grief and loss that has occurred across the globe. New diseases and new pandemics will continue to plague us in the future. I hope we rise from the ashes of COVID-19 with the understanding that we are all vulnerable, we are all human and we are strongest when we work together and see the humanity in each other.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

1. Creative problem solving — Leaders think outside the box. I was an innovator when I saw that we were treating nosebleeds inefficiently in the ER. Instead of following the status quo and taping together tongue depressors as my instructors suggested I came up with a novel nosebleed treatment device. I am now the CEO of a successful medical device startup and I expect NasaClip to become a household name for nosebleed rescue.
2. Balance — Life is a marathon, not a sprint. If you do not identify where wellness fits into your career and life you will burn out and regrettably lose out on impacting the world and those closest to you in the way that you desire. When I became a mother I instantly realized that I had to take care of myself and enjoy the little moments in life. First, it was clear that spending all my time thinking about the future or worrying about past mistakes was robbing me of the joy in the present. Second, I knew that my child was relying on me not just to be an excellent physician, a community leader, or a responsible parent, she needed me to be the best me and that required me to take care of myself, nurture myself and respect my needs.
3. Resilience — It is true that life will define you in its hardest moments. I remember that I was devastated after failing my emergency medicine boards by 1 point. I thought it was a catastrophic mistake that would ruin my career. It didn’t. I went back, changed how I studied, learned how to take the test, and always believed in my clinical skill and ability to be a superb physician. Now my fellow physicians call me when they have an issue or an illness and they want me to take care of their family members who may end up in the ED– clearly, they trust my knowledge and skill as a clinician and so do I.

Thank you for all that. Let’s now shift to the main focus of our interview. This might seem intuitive to you, but it would be helpful to articulate this expressly. Can you share three reasons with our readers why it’s really important for there to be more diversity in medicine?

• People have more trust in doctors they can relate to. Consider this. Black men live 4.6 years less than non-Hispanic white men. There are many reasons for this, including a lack of trust by Black in the healthcare system. Studies suggest that black patients feel a black doctor better understands their concerns. It facilitates communication and the sharing of potentially life-saving information that a patient and provider must exchange for care. In other words, the studies suggest that black patients trust black doctors.
• Communication seems to be better. A Harvard study shows that when Black patients saw non-black doctors, they received 18% fewer preventive services. It was a fascinating study. In the first stage, before meeting their doctor, participants selected the same number of preventive services, regardless of whether the doctor they saw was black. But in the second stage, after talking to their doctor, men who met with Black doctors elected to receive more preventive services — especially more invasive services that required a blood sample or injection — than men who met with non-Black doctors. Essentially, the rapport and communication between a black doctor and a black patient was better.
• Implicit bias must be addressed through a diverse workforce. The limited diversity in the field of medicine perpetuates racial biases and allows for antiquated and harmful norms to exacerbate health inequities. The demographics of this country are not mirrored in the predominantly White and male faces of physicians.7 In the last one hundred years, the percentage of physicians who are Black has barely risen.8 In 1900, 1.3 percent of physicians were Black; by 1940, the fraction had more than doubled to 2.8 percent; by 2018, almost eighty years later, still only 5.4 percent of physicians were Black, though Black people made up 13 percent of the total U.S. population.9 The disproportionately low number of Black physicians creates a dearth of perspectives and makes it harder to see how racist paradigms are influencing experiences and outcomes for patients, providers, and our society. If the field of medicine does not diversify who teaches, leads, and practices, then preferences such as “Whiteness” and other normative markers will remain the status quo, established by the majority, unfriendly as it may be for those who differ.

From my piece “Racism, Not Race: A Physician Perspective on Anti-Black Racism in America” https://onlinelibrary.wiley.com/doi/full/10.1002/hast.1365

For more information, I encourage you to read an article I wrote on the topic entitled: Diversity pipelines: The rationale to recruit and support minority physicians.

Source for stats: https://globalhealth.harvard.edu/when-black-patients-see-non-black-doctors/

As things stand today, what are the main barriers for black men and women to enter the medical field?

Recruitment — Many medical schools lack initiatives that target underrepresented populations and geographies. More emphasis is needed to encourage black men and women to enter medicine and other STEM programs. And those of us in these fields need to mentor and inspire more applicants.

The Admissions Process — The admissions process emphasizes undergraduate academic achievement. The MCAT exam is also a barrier as many applicants with less than optimal scores on the exam do not pass initial screenings. The process is difficult for all, but people of color are often disadvantaged in the process and studies have shown that lower scores are not linked to a difference in graduating, matching into residencies, or achieving board certification.

The Cost — Medical school can be cost-prohibitive. Applicants from lower socio-economic backgrounds face an uphill battle to cover the costs of MCAT preparation and application, and then, if accepted, tuition, residency costs and living expenses while in medical school. Many doctors graduate from medical school with a large amount of debt.

Source: https://www.sciencedirect.com/science/article/abs/pii/S1076633222004135

From your perspective, can you share a few things that can be done by the community, society, or the government, to help remove those barriers?

The most successful diversity pipeline programs have focused on academic enrichment (science and mathematics), admissions preparation, mentoring, financial support, psychosocial support, and professional opportunities.

Guidelines that mandate that medical institutions “must have policies and practices to achieve appropriate diversity among its students, faculty, staff, and other members of its academic community” and “must engage in ongoing, systematic, and focused efforts to attract and retain students, faculty, staff, and others from demographically diverse backgrounds,” are imperative.

What are your “5 things I wish someone told me when I first started my career in medicine,” and why? Please share a story or example for each.

1 . Enjoy the journey, be happy along the way.

2 . You will fail, learn from mistakes and look at them as an opportunity.

3 . Wellness is success, it’s hard to be successful if you aren’t happy.

4 . The road less traveled is fun and you will be rewarded for taking risks.

5 . Remember that you are your ancestors’ wildest dreams.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

Innovation helps all people, uplift innovation from all backgrounds.

One thing I see every day as a female entrepreneur of color is the lack of financing for women and minorities. Female founders secure only 2% of venture capital money, and Blacks receive less than 1%. We need to think about opportunities — the road to building generational wealth and uplifting communities that have been disadvantaged for too long is hidden in the early opportunities for growth. Take a risk on someone who doesn’t look like you, doesn’t sound like you, doesn’t think like you, who isn’t you. Innovation knows no bounds.

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.

I’d love to speak to Serena Williams about her journey as a black female entrepreneur and discuss opportunities with Serena Ventures to fund NasaClip.

How can our readers best continue to follow your work online?

youtube: https://www.youtube.com/@drelizpc
IG: https://www.instagram.com/drelizpc/
twt:https://twitter.com/DrElizPC
LI:https://www.linkedin.com/in/elizabethpclayborne/

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.